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Georgia scores low on health insurance

ATLANTA - Georgia gets poor grades in protecting consumers in the health insurance market, according to a recent nationwide survey of state insurance regulations by a consumer advocacy group.

When it comes to requiring insurers to sell policies to all applicants, preventing coverage from being revoked or regulating how insurers handle pre-existing conditions, Georgia received failing grades in the scorecard prepared by Families USA, a nonpartisan organization that bills itself as "the voice for health care consumers."

The group also gave the state low marks in the area of regulating the premiums insurers charge. Georgia received partial credit for its practice of reviewing some rates and premiums before insurers can begin using them.

Insurance Commissioner John Oxendine said the ratings view state policies through a lens that looks favorably on more heavier government regulation than Georgia's prevailing political philosophy is willing to offer.

"There are different theories about health care, and it appears Families USA has a certain approach," Oxendine said.

The scorecard gives high marks to Vermont, New York and Massachusetts, which have more of a hand in regulating insurers, Oxendine said. In Massachusetts, health insurance is compulsory.

Georgia could require insurers to offer coverage to all applicants, Oxendine said.

"What happens is the price goes up astronomically," he said.

The benefit of Georgia's approach is health insurance is cheaper than many other states, the commissioner said.

One bright spot among the state's poor scores is enforcement of rights; the state does allow for external reviews of denied benefits for some health plans, and decisions in those matters are binding.

Georgia was in crowded company with its low marks. All but five states received failing grades for not requiring insurers to sell policies to all applicants.

Families USA said its survey found states have greatly varying protections for consumers.

"The result is a patchwork of protections that, on the whole, leaves consumers to fend for themselves. Without adequate protections, insurers can deny coverage, charge exorbitant premiums, and even revoke people's policies without warning," the group said.

It urged a more uniform system of ensuring access and affordability in health coverage.